The invention relates to a medical cutting device for creating thin tissue or cartilage slices, comprising a device body and a cover, wherein a first holding device is provided, which includes a first working section comprising a first recess which is located on the top side of the device body, the recess being entirely or partially enclosed by a first limiting ridge. The device body comprises a connecting section which is directly, rigidly adjoined by the first working section. The cover comprises a counterpart to the connecting section which is directly, rigidly adjoined by a first pressure section. In the operating state of the cutting device, the first pressure section is disposed opposite the first recess in the first working section at an essentially uniform first distance da defined by the geometric shape of the connecting section and the counterpart thereof, and therefore a guide slot extending between the first working section and the first pressure section remains free for a cutting blade. The distance of the guide slot to the bottom surface of the first recess, which is defined by the distance da defines the thickness, which can be achieved with the aid of the first holding device, of a slice to be created by means of the cutting device.
A device of this type is known from DE 10 2013 105 856 B4.
Time and time again, it becomes necessary for various medical purposes to cut a piece of thin, endogeneous tissue, in particular cartilage slices having uniform thicknesses, out of a larger piece of cartilage which has been removed, for example, from the auricle, the tragus, the cartilaginous portion of the upper bony rib, or the nasal septum. For example, it can be necessary to examine special properties of the main body in greater detail, in particular under a microscope. In otorhinolaryngology, thin cartilage slices of this type are also required in many surgical applications, such as in the middle ear region to cover a middle ear prosthesis, to restore the posterior wall of the auditory meatus, or for the plastic repair of a defect of the tympanic membrane. Thin cartilage slices of this type are also used in many nasal surgeries, in order to perform functional or aesthetic corrections of the nose.
A cutting device is described in EP 0 483 567 B1, with the aid of which thin cartilage slices, which have a thickness which is predefinable within certain limits, can foe cut out of a larger piece of cartilage quickly, reliably, and with a consistent level of quality. In order to obtain different thicknesses of the cartilage slices that are created, however, special shims having a known thickness must be placed in the cutting device. These shims, similar to the cutting device itself, must be thoroughly cleaned and kept sterile, and they must be handled separately in this manner before every operation, which is a time-consuming process that is susceptible to error. Considering that an average ENT hospital has three to four surgical suites, and, at peak times, fifteen to twenty patients may be operated on in one day, it is possible that a cartilage cutter must be made available up to fifteen times a day. This poses a great logistical challenge in terms of supplying sterilized materials. Moreover, handling the shims is not entirely easy. For example, due to the small size of the shims, it is not always possible to label them adequately and in an easily recognized manner, even though this is necessary in order to ensure that precisely the proper shim having the particular size that is required is available during the operation. In addition, special skills are required to insert the relatively small shims into the cutting device correctly, and to fix them in position therein.
In order to ensure that thin cartilage slices having certain different thicknesses can be created in a consistent level of quality, even without using the known shims, it is provided according to US 2010/0236693 A1—as is also the case with the known cutting device according to EP 0 483 567 B1—that the first recess, which is disposed in the first working section on the top side of the device body, is closable via a first projection disposed on the top side of the cover, wherein the first lateral limiting ridge comprises a first guide slot for the insertion of a cutting blade, the guide slot extending from an end face of the first section at a predefined first distance in parallel to the bottom surface of the first recess. In addition, in the device according to US 2010/0286693 A1, at least one second holding device is to be provided, which comprises a second section including a second recess which is disposed on the top side of the device body and is entirely or partially enclosed by a second limiting ridge and is closable via a second projection which is disposed on the top side of the cover, wherein the second lateral limiting ridge comprises a second guide slot for the insertion of a cutting blade, the guide slot extending from an end face of the second section at a predetermined, second distance in parallel to the bottom surface of the second recess.
Since different distances between the particular guide slot and the corresponding bottom surface of the particular recess can foe selected for different holding devices, cartilage slices having certain different thicknesses can be created with the aid of this known cutting device including the different holding devices, without the need to use the shims which are indispensible in the previous prior art. In addition, a handling of this cutting device between the thumb and the index finger provides the operating surgeon with greater confidence during the actual cutting procedure, because all parts—due to the geometry and the design thereof—can be moved relative to each other in a reliable and controlled manner. The disadvantage of this known cutting device, however, is that the production of parts is highly complex. Products produced using injection-molding technology in particular have the characteristic that considerable problems can result when walls are very thin. As a consequence thereof, the products generally cannot be produced cost-effectively, due to the financial outlay involved.
DE 10 2013 105 857 B4 cited at the outset improves this prior art, in that it provides a modified cutting device—which is generic for the present invention—having the features defined at the outset. When this improved device is utilized, however, there is also a certain risk of injury for the person handling the device, because the cutting blade, before being inserted into the guide slot, is freely accessible and, therefore, can cut the user in the finger if a clumsy movement is carried out. Yet another disadvantage of this known device (as well as of the above-discussed prior art) is that the knife for cutting off the desired cartilage slice must be handled using sawing or chopping motions, which often results in non-uniform cutting results. In addition, the cutting procedure cannot be automated in any of the known devices, but rather absolutely must always be carried out manually.